Simmonds M J, Kumar S, Lechelt E
School of Physical Therapy, Texas Woman's University, Houston 77030.
Phys Ther. 1995 Mar;75(3):212-22. doi: 10.1093/ptj/75.3.212.
Despite the widespread use of spinal mobilization, little is known about the forces used or the accuracy of therapists in estimating the forces they use in administering the technique. The purposes of this study were to quantify the forces used and to determine the accuracy of therapists in applying forces on a mechanical model.
Ten physical therapists participated.
A spinal model was used to measure applied force and displacement under different conditions of stiffness. The therapists applied oscillatory posteroanterior mobilizations to the model under three different conditions of stiffness.
Mean peak forces across grades and stiffness levels ranged between 57.59 and 178.27 N. The forces were generally lower in the least stiff condition. Displacement varied with stiffness and mobilization grade. In the least stiff condition, the mean displacement varied between 2.25 and 3.45 mm for grades 1 to 4, respectively.
Inter-therapist variability was high, and there was a systematic bias in underestimating the magnitude of applied force and in overestimating motion. The variability in force application and the general overestimation of motion detection may explain the poor reliability of measurements obtained with clinical tests based on motion palpation.
尽管脊柱松动术被广泛应用，但对于所使用的力量以及治疗师在估计其实施该技术时所使用力量的准确性知之甚少。本研究的目的是量化所使用的力量，并确定治疗师在机械模型上施加力量的准确性。
十名物理治疗师参与。
使用脊柱模型测量在不同刚度条件下施加的力和位移。治疗师在三种不同刚度条件下对模型施加振荡性后前向松动术。
各等级和刚度水平下的平均峰值力在57.59至178.27牛顿之间。在最不僵硬的条件下，力量通常较低。位移随刚度和松动术等级而变化。在最不僵硬的条件下，1至4级的平均位移分别在2.25至3.45毫米之间变化。
治疗师之间的变异性很高，在低估施加力的大小和高估运动方面存在系统性偏差。力量施加的变异性以及对运动检测的普遍高估可能解释了基于运动触诊的临床试验所获得测量结果的可靠性较差的原因。
